NPI | 1790921914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-41757) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016015924) |
207Q00000X Family Medicine (Licence: PA OS015504) | |
Enumeration Date | 2008-12-17 |
Last Update Date | 2021-11-29 |